Arrhythmias associated with acute respiratory failure in patients with chronic airway obstruction.

Electrocardiograms of 70 patients with chronic airway obstruction were examined from 148 consecutive admissions for acute respiratory failure. Forty-seven percent of the patients had major sopraventricular or ventricular arrhythmias. These arrhythmias were documented on 36 percent of bospital mbidwns. Supraventricular arrhythmias were slihtiy more common than ventricular arrhythmias, the most frequent b e i i atrial tachycardia and mnltifocal atrial tachycardia. Supraventricular arrhythmias tended to recur. Ventriclllar arrhythmias were often preceded by premature ventricular contractions, supraventicular arrhythmb, or other ventricular arrhythmiss. Ventricular arrhythmias were associated with a poor prognosis; 70 percent of patients with ventricular arrhythmia died doring the hospital admission and none survived to the end of the study period. Tbese data suggest that continuous electrocardiographic monitoring of chronic airway obstruction patients with acute respiratory failure wonM be of value in predicting prognosis and identifying patients Wrely to develop serious arrhythmias; these findings may have therapeutic implications.